A direct blow to the scrotum can tear the tough outer coat of a testicle, the tunica albuginea, and let testicular tissue push out through the gap. Doctors call it testicular rupture. It is rare. Blunt injury is the more common cause, though a penetrating wound can do it too, and sports, accidents and assaults are the usual settings.
Spotting it
The signs are severe scrotal pain and swelling after the injury. The pain can spread to the lower belly, groin or back, and it does not ease with rest or painkillers. Some men feel sick or dizzy. The scrotum may look red, purple or bruised, which points to bleeding inside, and it may feel heavy.
Examination alone often cannot settle the question. Swelling, bruising and tenderness make the testicle hard to assess by hand. Doctors turn to scrotal ultrasound, which can show an uneven contour and patchy tissue, and Doppler ultrasound to check blood flow. If the scan is inconclusive and rupture cannot be ruled out, guidelines recommend surgical exploration.
Surgery and outlook
Treatment is surgery, and the sooner the better. The surgeon clears blood clots and hematoma, trims away tissue that has died and closes the tunica albuginea with absorbable stitches. When the testicle cannot be saved, it has to be removed in an operation called an orchiectomy. One healthy testicle can still handle hormone and sperm production.
The encouraging part: the American Urological Association guideline reports that 80 to 90 percent of testicles are saved when surgery is prompt.
Waiting is what hurts. Delayed cases can bring chronic pain and testicular atrophy, and fertility and testosterone production may suffer.
After surgery, patients are generally told to use ice packs and pain relief, such as acetaminophen or ibuprofen, and to skip heavy lifting and sex for a few weeks. Light activity can often start within days. Follow-up visits let the surgeon check the healing. The injury also takes an emotional toll, and anxiety about fertility is common. Talking with family, friends or a counselor can help.
Protection
Athletes in contact sports such as football and hockey should wear a protective cup or jockstrap. Cyclists can wear padded shorts. Any man with severe testicular pain, swelling or discoloration after a blow should get medical care right away, because the pain can fade while the damage stays. Talk to your doctor or a urologist about any concern, and see one promptly if you find a lump or a change in size or shape.
Consult your doctor for medical advice.
Sources
- Testicular rupture – Wikipedia
- Ruptured Testicle: Symptoms, Causes & Treatment | Acibadem Health Point
